scholarly journals Predictors for the development of preoperative oxygenation impairment in acute aortic dissection in hypertensive patients

2020 ◽  
Author(s):  
Xuemin Zhao ◽  
Mengjun Bie
Keyword(s):  
Body Temperature ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Linear Regression Analysis ◽  
Oxygenation Index ◽  
Operating Characteristics ◽  
Laboratory Findings ◽  
Hypertensive Patients ◽  
Serum Crp ◽  
Oxygenation Impairment

Abstract Background Acute aortic dissection (AAD) is an acute life-threatening cardiovascular disease, which is frequently complicated with oxygenation impairment (OI). Objective We aim to investigate predictors of the development of OI in the patients with AAD. Methods We retrospectively collected clinical data of AAD in hypertensive patients from July 2012 to March 2020. The patients included in this study were divided into OI (+) group (oxygenation index ≤ 200) and OI (-) group (oxygenation index > 200). Both groups were compared according to demographic and clinical characteristics, and laboratory findings. Characteristics of hypertension in the patients with AAD were described. Predictors for the development of OI were assessed. And cutoff values were determined by receiver operating characteristics (ROC) curve. Results A total of 208 patients were included in this study and the incidence of OI was 32.2%. In OI (+) group, patients had significantly higher peak body temperature (37.85 ± 0.60 vs 37.64 ± 0.44℃, P = .005), higher levels of CRP (42.70 ± 28.27 vs 13.90 ± 18.70 mg/L, P = .000) and procalcitonin (1.07 ± 3.92 vs 0.31 ± 0.77ug/L, P = .027), and lower levels of albumin (34.21 ± 5.65 vs 37.73 ± 4.70 g/L, P = .000). Spearman’s rank correlation test showed that the minimum oxygenation index was positively correlated with albumin, and was negatively correlated with the peak body temperature, serum CRP, procalcitonin, BNP and troponin. The stepwise multiple linear regression analysis showed that the peak body temperature, serum CRP and albumin were independently associated with development of OI. An optimal cutoff value for CRP for predicting OI was ≥ 9.20 mg/L, with a sensitivity of 91.0% and a specificity of 61.0%. Conclusions The peak body temperature, serum CRP and albumin were independent predictors of OI development in the patients with AAD. The serum CRP on admission ≥ 9.20 mg/L might be a valuable and reliable indicator in predicting the development of OI.

scholarly journals Predictors for the development of preoperative oxygenation impairment in acute aortic dissection in hypertensive patients

2020 ◽  
Author(s):  
Xuemin Zhao ◽  
Mengjun Bie
Keyword(s):  
Body Temperature ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Linear Regression Analysis ◽  
Oxygenation Index ◽  
Operating Characteristics ◽  
Laboratory Findings ◽  
Hypertensive Patients ◽  
Serum Crp ◽  
Oxygenation Impairment

Abstract Background Acute aortic dissection (AAD) is an acute life-threatening cardiovascular disease, which is frequently complicated with oxygenation impairment (OI). We aim to investigate predictors of the development of OI in the patients with AAD.Methods We retrospectively collected clinical data of AAD in hypertensive patients from July 2012 to March 2020. The patients included in this study were divided into OI (+) group (oxygenation index≤200) and OI (-) group (oxygenation index>200). Both groups were compared according to demographic and clinical characteristics, and laboratory findings. Characteristics of hypertension in the patients with AAD were described. Predictors for the development of OI were assessed. And cutoff values were determined by receiver operating characteristics (ROC) curve.Results A total of 208 patients were included in this study and the incidence of OI was 32.2%. In OI (+) group, patients had significantly higher peak body temperature (37.85±0.60 vs 37.64±0.44℃, P= .005), higher levels of CRP (42.70±28.27 vs 13.90±18.70mg/L, P= .000) and procalcitonin (1.07±3.92 vs 0.31±0.77ug/L, P= .027), and lower levels of albumin (34.21±5.65 vs 37.73±4.70g/L, P= .000). Spearman’s rank correlation test showed that the minimum oxygenation index was positively correlated with albumin, and was negatively correlated with the peak body temperature, serum CRP, procalcitonin, BNP and troponin. The stepwise multiple linear regression analysis showed that the peak body temperature, serum CRP and albumin were independently associated with development of OI. An optimal cutoff value for CRP for predicting OI was ≥9.20 mg/L, with a sensitivity of 91.0% and a specificity of 61.0%.Conclusions The peak body temperature, serum CRP and albumin were independent predictors of OI development in the patients with AAD. The serum CRP on admission≥9.20 mg/L might be a valuable and reliable indicator in predicting the development of OI.

Abstract 3307: Early Use of Beta-blockers Attenuates Systemic Inflammatory Response and Lung Oxygenation Impairment after Distal Type Acute Aortic Dissection

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Yusuke Jo ◽  
Toshihisa Anzai ◽  
Yasuo Sugano ◽  
Hidehiro Kaneko ◽  
Kotaro Naito ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Aortic Dissection ◽  
Beta Blocker ◽  
Acute Aortic Dissection ◽  
Beta Blockers ◽  
Early Use ◽  
Lower Maximum ◽  
Wbc Count ◽  
Serum Crp ◽  
Oxygenation Impairment

BACKGROUND: Systemic activation of the inflammatory system after aortic injury may play a role in the development of lung oxygenation impairment (LOI) in patients with acute aortic dissection (AAD). We have reported that serum C-reactive protein (CRP) elevation is an independent predictor of this complication. We evaluated the effect of beta-blocker on systemic inflammation and the development of LOI after distal type AAD. METHODS: A total of 49 patients, who were admitted with distal type AAD and treated conservatively, were examined. Patients were divided into 2 groups according to the presence or absence of beta-blocker treatment, started within 24 hours of the onset. White blood cell (WBC) count, serum CRP level and arterial blood gases were measured serially. Clinical outcome, maximum WBC count, maximum CRP level, and lowest PaO 2 /FiO 2 (P/F) ratio were compared between the two groups. RESULTS: There was no difference between the groups in patients’ backgrounds, blood pressure, serum level of CRP, WBC count and P/F ratio on admission. Beta-blocker treatment was associated with lower maximum WBC count (14,856 ± 3201 vs. 11,687 ± 2610 /mm 3 , p =0.0028) and lower maximum serum CRP level (28.2 ± 20.5 vs. 14.2 ± 5.6 mg/dl, p =0.0004). The minimum P/F ratio was higher in patients with beta-blocker than in those without (140 ± 41 vs. 226 ± 90 mmHg, p =0.0076). Multivariate analysis revealed that administration of a beta-blocker was an independent negative determinant of LOI (P/F ratio ≤ 200 mmHg). CONCLUSIONS: Early use of beta-blockers prevented excessive inflammation and LOI after distal type AAD, suggesting a pleiotropic effect of beta-blockers on the inflammatory response after AAD.

scholarly journals The diagnostic value of D-dimer in acute aortic dissection: a meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jian Yao ◽  
Tao Bai ◽  
Bo Yang ◽  
Lizhong Sun
Keyword(s):  
Aortic Dissection ◽  
Likelihood Ratio ◽  
Acute Aortic Dissection ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Operating Characteristics ◽  
Meta Regression ◽  
D Dimer

Abstract Objective This study aims to evaluate the diagnostic value of D-dimer for acute aortic dissection (AAD) by the method of meta-analysis. Methods PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang databases from the establishment of the databases to December 2020 were systematically searched, and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) system was used to evaluate the quality of the literature. STATA 15.0 software was applied to calculate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (+LR), negative likelihood ratio (−LR) to draw summary receiver operating characteristics (SROC) curve and calculate the area under the curve (AUC). Meta-regression and subgroup analyses were used to explore the source of heterogeneity. Results A total of 16 clinical studies were enrolled in this study, including 1135 patients. The results of the meta-analysis showed that the pooled sensitivity was 0.96 (95% CI 0.91–0.98), the pooled specificity was 0.70 (95% CI 0.57–0.81), and the pooled DOR was 56.57 (95% CI 25.11–127.44), the pooled +LR was 3.25 (95% CI 2.18–4.85), the pooled −LR was 0.06 (95% CI 0.03–0.12), and the AUC was 0.94 (95% CI 0.91–0.95). Meta-regression and subgroup analysis results showed that publication year, sample size and cutoff value might be sources of heterogeneity. When the concentration of D-dimer was less than or equal to 500 ng/ml, the sensitivity significantly increased. Conclusion D-dimer has an excellent diagnostic value for AAD. It is a useful tool for detecting suspected AAD because of the excellent pooled sensitivity. D-dimer ≤ 500 ng/ml increases the potential to identify the suspected patients with AAD.

The coexistence of acute aortic dissection with autosomal dominant polycystic kidney disease - description of two hypertensive patients

2004 ◽  
Vol 13 (5) ◽  
pp. 283-286 ◽  
Author(s):  
Mariola Pe¸czkowska ◽  
Andrzej Januszewicz ◽  
Władysław Grzeszczak ◽  
Dariusz Moczulski ◽  
Hanna Janaszek-sitkowska ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Aortic Dissection ◽  
Polycystic Kidney Disease ◽  
Autosomal Dominant ◽  
Acute Aortic Dissection ◽  
Polycystic Kidney ◽  
Hypertensive Patients ◽  
Autosomal Dominant Polycystic Kidney

scholarly journals Interleukin-18 Expression Increases in the Aorta and Plasma of Patients with Acute Aortic Dissection

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Haiying Hu ◽  
Guangtai Zhang ◽  
Huanli Hu ◽  
Wenjing Liu ◽  
Jixiang Liu ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Linear Regression Analysis ◽  
Human Aorta ◽  
Interleukin 18 ◽  
Macrophage Differentiation ◽  
Vascular Smcs ◽  
M1 Macrophage ◽  
Underlying Mechanisms

Background. Interleukin- (IL-) 18 is a proinflammatory cytokine related to cardiovascular diseases, including hypertension and atherosclerosis. This study is aimed at determining whether IL-18 is related to aortic dissection (AD) and identifying the underlying mechanisms. Methods. IL-18 expression in human aorta samples from AD (n=8) and non-AD (NAD, n=7) patients was measured. In addition, the IL-18, IL-6, interferon- (IFN-) γ, and IL-18-binding protein (IL-18BP) concentrations in plasma samples collected from the NAD and AD patients were detected. The effects of IL-18 on macrophage differentiation and smooth muscle cell (SMC) apoptosis were investigated in vitro. Results. IL-18 expression was significantly increased in the aorta samples from the AD patients compared with those from the NAD patients, especially in the torn section. Aortic IL-18 was mainly derived from macrophages and also partly derived from CD4+ T lymphocytes and vascular SMCs. Plasma IL-18, IFN-γ, and IL-6 levels were significantly higher in the AD group than in the NAD group, and the IL-18 levels were positively correlated with the IFN-γ and IL-6 levels. In addition, plasma IL-18BP and free IL-18 levels were also elevated in the AD group. Linear regression analysis showed that the IL-18 level was independently associated with the presence of AD. In addition, anti-mouse IL-18-neutralizing monoclonal antibodies (anti-IL-18 nAb) inhibited angiotensin II-induced M1 macrophage differentiation and SMC apoptosis in vitro. Conclusion. IL-18 may participate in AD by regulating macrophage differentiation and macrophage-induced SMC apoptosis.

scholarly journals Predictors of oxygenation impairment in medical treatment for type B acute aortic dissection

2018 ◽  
Vol 33 (12) ◽  
pp. 1463-1470 ◽  
Author(s):  
Yusuke Kashiwagi ◽  
Kimiaki Komukai ◽  
Kenichiro Suzuki ◽  
Yuhei Oi ◽  
Mitsutoshi Tominaga ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Medical Treatment ◽  
Acute Aortic Dissection ◽  
Type B ◽  
Oxygenation Impairment

scholarly journals Predicting the Occurrence of Oxygenation Impairment in Patients with Type-B Acute Aortic Dissection

2014 ◽  
Vol 23 (01) ◽  
pp. 053-060 ◽  
Author(s):  
Kazunori Tomita ◽  
Nobuaki Kobayashi ◽  
Takuro Shinada ◽  
Akihiro Shirakabe ◽  
Noritake Hata
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Type B ◽  
Oxygenation Impairment
Sign in / Sign up

Export Citation Format

Share Document